Pharmacology

Question 1

what is the mechanism of H2 blockers?

Answer 1

Reversible block of histamine H2 receptors to decrease H+ secretion by parietal cells.

Question 2

What are the indications for H2 blockers?

Answer 2

Peptic ulcer, gastritis, esophageal reflux.

Question 3

What are the SE of H2 blockers?

Answer 3

Prolactin release; Gynecomastia
Decrease libido; Impotence in males
Cimetidine inhibits P450

Question 4

What are the H2 blockers?

Answer 4

Cimetidine, Ranitidine, Famotidine, Nizatidine

Question 5

What is the mechanism of action of Proton Pump Inhibitors?

Answer 5

Irreversibly inhibit H+/K+ATPase in stomach, decreases Proton secretion in Parietal cells.

Question 6

What are the indications for Proton Pump Inhibitors?

Answer 6

Peptic ulcer, gastritis, Midesophageal reflux.

Zollinger-Ellison Syndrome

Question 7

What are the Proton Pump Inhibitors?

Answer 7

Omeprazole, Lanzoprazole, Esomeprazole Pantoprazole & Dexlansoprazole

Question 8

What are the SE of Proton Pump Inhibitors?

Answer 8

Increased Risk of C. difficile infection
Pneumonia
Hip fracture
Decrease of serum MG2+

Question 9

What is the Mechanism of Action of Misoprostol?

Answer 9

PGE1 analog; Increase production and secretion of gastric mucous barrier, decreased acid production

Question 10

What are the indications for Misoprostol?

Answer 10

Prevent (Non-Steroidal Anti-Inflammatory Drug) NSAID- induced peptic ulcers; maintenance of a Patent Ductus Arteriosus; induce labor.

Question 11

What are the SE of Misoprostol?

Answer 11

Diarrhea; contraindicated in women of childbearing potential, abortion inducing drug.

Question 12

What is the mechanism of Action of Octreotide?

Answer 12

Long-acting somastotatin analog

Question 13

What are the indiction for Octreotide?

Answer 13

Acute Variceal Bleeds
Acromegaly
VIPoma
Carcinoid tumors

Question 14

What are the SE of Octreotide?

Answer 14

Nausea, cramps, Steatorrhea

Question 15

What is the mechanism of action of Bismuth and Sucralfate?

Answer 15

Bind ulcer base, providing physical protection allows bicarbonate ion secretion to reestablish PH gradient in the mucous layer

Question 16

What is Bismuth and Sucralfateused for?

Answer 16

Increase ulcer healing; travelers diarrhea.

Question 17

What is the Mechanism of Action Infliximab?

Answer 17

Crhon disease, ulcerative colitis, rheumatoid arthritis, ankylosing spondylitis, Psoriasis

Question 18

What are the SE of Infliximab?

Answer 18

Respiratory infection(including reactivation of latent TB) fever, Hypotension.

Question 19

What is the Mechanism of action of Sulfasalazine?

Answer 19

A combination of sulfapyridine(antibacterial) and 5-aminosalicylic acid (anti-inflammatory) activated by colonic bacteria.

Question 20

What are the indications for Sulfasalazine?

Answer 20

Ulcerative colitis, Crohn disease

Question 21

What are the SE of Sulfasalazine?

Answer 21

Malaise, Nausea, Sulfonamide toxicity, reversible oligospermia.

Question 22

What is the Mechanism of action of Ondansetron?

Answer 22

5-HT3 antagonist; powerful central acting antiemetic

Question 23

What are the indications for Ondansetron?

Answer 23

Control vomiting in patients undergoing Chemotherapy and postoperatively

Question 24

What are the SE of Ondansetron?

Answer 24

Headache, constipation, dizziness

Question 25

What is the Mechanism of action of Osmotic Laxatives?

Answer 25

Provide osmotic load to draw water out Lactulose treats hepatic encephalopathy; gut flora degrades it into metabolites(lactic acid and acetic acid) that promote nitrogen excretion as NH4+

Question 26

What are the indications for Osmotic Laxatives?

Answer 26

Constipation

Question 27

What are the SE of Osmotic Laxatives?

Answer 27

Diarrhea, dehydration, may be abused by bulimics

Question 28

What are the Osmotic Laxatives?

Answer 28

Magnesium hydroxide(can cause Diarrhea, Hyporeflexia, hypotension, cardiac arrest) Magnesium citrate, Polyethylene glycol, Lactulose

Question 29

What is the Mechanism of action of Metoclopromide?

Answer 29

D2 receptor antagonist; increase resting tone; contractility LES tone, motility. Does not influence colon transport time.

Question 30

What are the indications for Metoclopromide?

Answer 30

Diabetic and post-sugary gastroparesis.

Question 31

What are the SE of Metoclopromide?

Answer 31

increase parkinsonian effects. Restlessness, drowsiness, fatigue, depression, nausea, diarrhea. Drug interaction with digoxin and diabetic agents, Contraindicated in small bowel obstruction.